Aortic-Right Atrial Fistula Diagnosed at Cardiac Rehabilitation Center Early after Ascending Aorta and Aortic Valve Replacement Surgery

Abstract

We reported a case of 59-years old man referred to residential cardiac rehabilitation after complex cardiac surgery (replacement of the ascending aorta above the sino-tubular junction with woven Dacron vascular prosthesis Intervascular 26, re-implantation of the right coronary artery and aortic valve replacement with stented biological prosthesis after diagnosis of aortic disease characterized by aortic root dilation, ascending aortic aneurysm and moderate aortic regurgitation) where echocardiography performed on admission at the rehabilitation setting diagnosed an aorto-right atrial fistula despite a nearly normal clinical and functional assessment. The patient, consequently, underwent a new cardiac surgery with complete recovery. Both echocardiography and a functional assessment was performed at the admission and after one-year follow-up. This case report emphasizes the importance of echocardiography examination after cardiac surgery in cardiac rehabilitation setting, even with the lack of clear clinical, functional or laboratory suspects of infection or in absence of known surgical complications.